NPIMap

Organization Active NPI

Lakeside Dental Care

  • General Practice Dentistry
  • Metairie, LA
National Provider Identifier
1447385885
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5293 Issued in LA
Legal business name
LAKESIDE DENTAL CARE
Practice address
3000 W Esplanade Ave N
Suite 200
Metairie, LA 70002-1877
Phone
(504) 833-3200
Fax
(504) 833-0813
NPI assigned
Feb 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lesley E Groetsch
Title
Operations Manager
Phone
(504) 833-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5293 LA Primary

Addresses

Primary practice location

3000 W Esplanade Ave N
Suite 200
Metairie, LA 70002-1877

Mailing address

1000 CW Fagan Drive
Suite a
Hammond, LA 70403
Phone (985) 345-4166

National Provider Directory

National Provider Directory
Tax ID family
Cheng You DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3000 W Esplanade Ave N
Ste 200
Metairie, LA 70002
Phone (504) 833-3200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447385885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CW FAGAN DRIVE",
            "address_2": "SUITE A",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "70403",
            "telephone_number": "985-345-4166",
            "fax_number": "985-345-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 W ESPLANADE AVE N",
            "address_2": "SUITE 200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700021877",
            "telephone_number": "504-833-3200",
            "fax_number": "504-833-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROETSCH",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "504-833-3200"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.